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Agenda and minutes

Contact: Peter Moore  020 7527 3252

No. Item




The Chair introduced Members and officers to the meeting


Apologies for Absence


Councillor Chowdhury


Declaration of Substitute Members




Declarations of Interest

If you have a Disclosable Pecuniary Interest* in an item of business:

§  if it is not yet on the council’s register, you must declare both the existence and details of it at the start of the meeting or when it becomes apparent;

§  you may choose to declare a Disclosable Pecuniary Interest that is already in the register in the interests of openness and transparency. 

In both the above cases, you must leave the room without participating in discussion of the item.

If you have a personal interest in an item of business and you intend to speak or vote on the item you must declare both the existence and details of it at the start of the meeting or when it becomes apparent but you may participate in the discussion and vote on the item.


*(a)Employment, etc - Any employment, office, trade, profession or vocation carried on for profit or gain.

 (b)Sponsorship - Any payment or other financial benefit in respect of your expenses in carrying out

  duties as a member, or of your election; including from a trade union.

 (c)Contracts - Any current contract for goods, services or works, between you or your partner (or a body

 in which one of you has a beneficial interest) and the council.

 (d)Land - Any beneficial interest in land which is within the council’s area.

 (e)Licences- Any licence to occupy land in the council’s area for a month or longer.

 (f)Corporate tenancies - Any tenancy between the council and a body in which you or your partner have

  a beneficial interest.

 (g)Securities - Any beneficial interest in securities of a body which has a place of business or land in the council’s area, if the total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body or of any one class of its issued share capital. 


This applies to all members present at the meeting.






Minutes of the previous meeting pdf icon PDF 127 KB




That the minutes of the meeting held on 15 July 2019 be confirmed as a correct record of the proceedings and the Chair be authorised to sign them


Chair's Report


The Chair stated that the order of the agenda would be as published.


The Chair added that she had been approached to discuss installation of 5G masts at the Committee, however due to the busy schedule of the Committee agendas and Government advice that 5G is safe this would not be considered at the present time.


Public Questions

For members of the public to ask questions relating to any subject on the meeting agenda under Procedure Rule 70.5. Alternatively, the Chair may opt to accept questions from the public during the discussion on each agenda item.


The Chair outlined the procedure for Public questions, filming and recording of meetings, and Fire Evacuation Procedures


Health and Wellbeing Board Update - Verbal




Whittington NHS Trust - Performance Update/Quality Account pdf icon PDF 4 MB


Michelle Johnson, Chief Nurse and Director of Patient Experience, and Jonathan Gardner, Director of Strategy and Commissioning, Whittington NHS Trust were present for discussion of this item.


Whittington NHS Trust made a presentation to the Committee, a copy of which is interleaved.


During discussion the following main points were made –


·         There were 108,651 visits to A&E in 2018/19, and 2,224 elective admissions. There has been a 10% increase in A&E attendance in the past year. Work is taking place with primary care and other partners to reduce this number. There were a number of reasons why people were attending A&E but this placed a strain on the Trusts resources

·         It was noted that new procedures had been introduced in ambulatory care which were proving beneficial

·         The maternity staff delivered 3,478 babies, and there were 793,423 contacts with patients in the community

·         The Trust had an annual turnover of £348m, and employs over 4,200 staff. The Trust also works with over 190 volunteers, who support the Trust

·         There have been positive maternity survey results

·         The Trust has the third highest uptake of flu vaccine by staff across London, and the proportion of staff taking part in the staff survey rose to 49.8%

·         The Trust held its first annual staff awards, and was placed 35 overall in the UK, and second in London from the National Cancer Experience Survey

·         The Trust has implemented the updated National Early Warning Score 2 system

·         The Trust participated in 100% of relevant national clinical audits, and 100% of national confidential enquiries

·         Trust staff have received a number of awards, and nominations, in 208/19

·         Financially, the Trust delivered against its year end control total of £22.7m. The financial performance made the Trust eligible for £6.2m in additional incentive and Provider Sustainability Fund funding from NHS Improvement

·         For 2018/19 the Trust reported an adjusted surplus of £28.2m, including £27.6m of PSF income

·         Whilst the Trust met its financial targets for 2018/19, it fell short of its Cost Improvement Target by c£5m, delivering £11.5m versus £16.5m. This creates an additional pressure for the 2019/20 financial year

·         In 2018/19 the Trust set itself 30 quality priorities covering 14 domains. These covered Patient Safety, Patient Experience, and Clinical Effectiveness. The priorities were identified following consultation with staff, managers and stakeholders. The Trust met 25 of its quality priorities, and moved forward significantly with the remainder

·         A number of achievements have been made in 2018/19 in the review of priorities performance including – Family and Friends test results for Podiatry has shown an increase of 150% over the year, due to the utilisation of SMS Friends and Family links sent to patients, and enhanced focus on collecting feedback amongst local teams. A Frailty pathway has been developed for urgent and emergency hospital care. A delirium rapid assessment test, and Delirium Care Plan have been introduced. In addition, an increased number of patients have been recruited to research studies, with 1,023 patients, compared to 751 in 2017/18. Falls -  ...  view the full minutes text for item 100.


Scrutiny Review - Adult Paid Carers - Witness evidence - Verbal


Carers from MiHomecare were present and made statements to the Committee, following which questions were asked by Members of the Committee.


Ian Haddington, MiHomecare, and Heidi Wildman London Care were also present.


During discussion the following points were made –


·         Carers stated that they worked in the caring profession as they found it rewarding, and had moved into the service often after caring for a relative or a friend

·         Carers stated that they enjoyed caring for the elderly, however they expressed concern that they were not paid additional money for working at weekends or after 6p.m. and that there should be an increase in pay for carers

·         In response to a question carers were broadly in favour of more guaranteed hours contracts, and that zero hours contracts did not give security of remuneration. If clients went into hospital then a carer lost pay and this was not considered to be fair to carers. This was due to funding being ceased from the LA as the care package is not required when a client goes into hospital

·         MiHomecare stated that guaranteed contracts were offered to all carers, after completing their probationary period, but they had to commit to working 30 hours per week but this could often involve late night or weekend working, which many carers did not wish to commit to. Many carers wished to do 9-5 and this was not always possible with guaranteed hours contracts

·         Discussion took place as to the hours of carers, and it was stated that some clients did not want to go to bed until 10.00p.m. and this led to a long day as carers would often have to start early in the morning. Most of the carers duties took place in the morning, and in the early evening, and there was a lot of downtime if clients wanted to be put to bed late at night. This led to carers working a long day, from early in the morning to late at night, however their pay did not reflect this

·         Reference was also made to the fact that in some instances carers faced abuse, possible violence, or racist attitudes towards them by clients and that this should not be acceptable. The view was expressed that there should be a zero tolerance policy adopted to prevent this. It was stated that whilst appreciating that this should not be acceptable, if clients persisted it would be difficult for a Local Authority to withdraw care. It was noted that at present when there is a difficult client they are often placed with an alternative provider, which just passes the problem on

·         Concern was also expressed by carers that there appeared to be long periods whereby concerns were expressed by carers about clients, and action being taken by Social Services. MiHomecare stated that they did report concerns and while action is taken quickly by Social Services quickly in many instances, because of pressures on the system, this was not always the case

·         Carers informed the Committee  ...  view the full minutes text for item 101.


Performance Indicators - Quarters 3/4 pdf icon PDF 156 KB


Councillor Janet Burgess, Executive Member Health and Social Care, and Shakaut Mahnaz, Public Health, were present for discussion of this item.


During discussion the following main points were made –


·         Social care delayed transfers of care have trended upwards, and there was an average total of social care delayed beds per day of 6.5 at the year end, missing the target of 5 beds per day. Measures are being taken to improve this

·         Discharge to home or community care – at end of 2018/19, 95% of people discharged from hospital into enablement services were at home, or in a community setting 91 days after the discharge meeting, therefore meeting the target of 95%

·         Direct payments – currently 23% of all Islington community care, and support, is provided through direct payments. The total number of service users in the community receiving services has increased from 591 to 675, from the beginning of the year, however there had been a change in the method of calculation

·         The target for the placement of residents going into residential, and nursing care, has slightly increased from the target of 130 to 139

·         Reducing social isolation – results from the 2018/19 survey show an improved percentage of working age adults known to Adult Social Care, that feel that they have adequate or better social contact, increasing to 78% from 70% (in 2017/18)

·         Public Health – smoking reduction is once again above target. There is effective detection of health risks through NHS national health checks, and performance is on target for 2018/19

·         Mental health issues – in 2018/19 over 5,000 people accessed support for common mental health problems through IAPT. Performance is slightly below the annual target, but shows an improvement from last year. The percentage of Islington residents entering IAPT treatment who recover, is above the nationally set target (50%), at 52%

·         Substance misuse – in 2018/19 10.4% of drug users in treatment during the year successfully completed treatment, and did not re-present within 6 months of treatment. This is significantly below the target of 20%, and a reduction in performance from last year. Similarly, in 2018/19 the proportion of alcohol users who successfully completed a treatment plan was below target 27.2%, as opposed to 40%. A new integrated substance misuse treatment and recovery service was procured, and commenced, at the start of 2018/19, which has impacted on performance figures. However, the performance figures for April/May has shown an improvement

·         Improved sexual health – the number of Islington women prescribed long term acting reversible contraception in 2018/19 has substantially exceeded the annual target



That the report be noted


Work Programme 2019/20 pdf icon PDF 49 KB




That, subject to the LAS Quality report, scheduled for the October meeting, being placed on the November meeting of the Committee agenda, the report be noted